Improve care for prisoners with dementia, RCN urges

The RCN has called for improved care for prisoners with dementia after a watchdog revealed an inmate with the condition was kept handcuffed in hospital until shortly before his death.

The RCN has called for improved care for prisoners with dementia after a government ombudsman revealed an inmate with the condition was kept handcuffed in hospital until shortly before his death.

A report by the prisons and probation ombudsman found older and infirm prisoners are often restrained inappropriately when travelling to and from hospital for appointments and treatment.

Figures from the Mental Health Foundation suggest about 5% of prisoners over 55 years old in England and Wales have dementia, meaning there are likely several hundred prisoners with the condition.

Low risk

The ombudsman report highlights the case of a 72-year-old prisoner with dementia, who was attached to an officer via an 'escort chain' , which has a handcuff at each end, for two days while in hospital with pneumonia.

This was despite the fact the man, who used crutches and a wheelchair due to poor mobility, was deemed of low risk to the public.

A nurse who carried out a risk assessment before the prisoner was taken to hospital pointed out he was only able to take a few steps at best, and was in a very confused state of mind

Prisons and probation ombudsman Nigel Newcomen, urged the prison service to improve the way it dealt with growing numbers of older prisoners who may have age-related conditions such as dementia.

The report also found:

  • When someone has dementia, they may, over time, lose the capacity to make decisions about their care and treatment.
  • A lack of appropriate space or facilities can make it difficult for prisons to provide care that would be equivalent to that in the community.
  • Prisoners are likely to need support, such as with collecting their food and cleaning their cells and, when used effectively, prisoner carers can provide essential support to prisoners with dementia.

The over-60s are the fastest-growing age group in the prison population, according to the report. The Ministry of Justice projects the number of prisoners aged 60 or over will increase from current figures of 4,100 up to 5,500 in 2020.

Clear signage

The report recommended that risk assessments for using restraint take into prisoners’ health, mobility and mental capacity.

Nurses and other professionals working with prisoners with dementia should also ensure they have access to a dementia-friendly environment, with measures including clear signage.

Family members should also be involved in decisions about their relative's care, the report added.

RCN professional lead for older people and dementia care Dawne Garrett said: ‘It is important that people with dementia receive the right care wherever they are.

‘Prisons were not designed to meet the needs of older people with dementia, but as with wider society, changing demographics mean we all need to be aware of these needs in every setting.’

Learning Lessons Bulletin: Dementia

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